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"Tuberkulosis (TB) sampai dengan saat ini masih merupakan salah satu masalah kesehatanutama di Indonesia. Sepuluh persen dari TB ekstraparu adalah TB tulang, dan sekitar 50%penderita TB tulang menyerang tulang belakang (Spinal Tuberkulosis). Respon tubuhterhadap Mycobacterium tuberculosis (M.tb) sehingga menimbulkan penyebaranekstraparu, khususnya respon makrofag sebagai pertahanan lini pertama, masih belumsepenuhnya dimengerti. Makrofag menghasilkan molekul reactive oxygen species (ROS)sebagai hasil dari oxygen burst untuk mengeliminasi antigen. Nitrat Oksida (NO) danmieloperoksidase (MPO) berperan pada oxygen burst Selain itu, Pada fagositosisterdapat organel lisosom yang di dalamnya terdapat enzim hidrolase (fosfatase asam danbeta glukuronidase) berguna pada pencernaan intraseluler. Penelitian ini mengujihipotesis bahwa ada gangguan fungsi makrofag pada pasien TB tulang belakang. Monositdiisolasi dari peripheral blood mononuclear cells (PBMC) dari lima pasien TB tulangbelakang dan lima orang sehat sebagai kontrol. Monosit yang terisolasi dikultur denganstimulasi dari macrophage colony-stimulating factor (M-CSF) selama tujuh hari untukpematangan. Kemampuan fagositosis makrofag dinilai aktivitasnya terhadapa sel darahmerah domba (SDMD). Sedangkan nitrat oksida (NO), mieloperoksidase (MPO), betaglukuronidase,dan aktivitas fosfatase asam diselidiki dengan metode spektrofotometer.Analisis data dengan menggunakan aplikasi SPSS versi 20. Kami menemukan bahwamonosit yang diisolasi dari PBMC pasien TB tulang belakang secara signifikan lebihsedikit dibandingkan dengan kelompok kontrol (2992.103 vs 6474.103 (sel / mL)) danjuga lebih sedikit makrofag yang melekat pada sel darah merah domba (SDMD) (264.103vs 598.103 (sel / mL)). Namun, produksi NO (2346 vs 325,17 (μmol / gram protein)), danMPO (570,7 vs 17,4 (unit / mg), beta-glukuronide (0,149 vs 0,123 (unit / mg)), dan asamfosfatase aktivitas (1776,9 vs 287,9 (unit / mg)) dari makrofag kelompok TB tulangbelakang lebih tinggi daripada kelompok yang sehat serta korelasi negatif kuat danbermakna antara fagositosis makrofag dengan tiap variabel tersebut. Selain itu, Terdapatkorelasi positif lemah dan tidak bermakna antara kejadian fagositosis dan uji WST.Meskipun pengenalan rendah pada benda asing, proses makrofag intraseluler, termasukaktivitas oksidatif dan fungsi lisosom, tinggi secara signifikan. Hasil ini menunjukanpenurunan fungsi makrofag pada pasien TB tulang belakang serta terdapat kemungkinanadanya dominasi imunitas non-spesifik bawaan pada infeksi TB tulang belakangTuberculosis (TB) is still one of the main health problems in Indonesia. Ten percent ofextrapulmonary TB is bone TB and about 50% of people with bone TB affected to thespine. The immune response against Mycobacterium tuberculosis (M.tb), which causesextrapulmonary spread, particularly the response of macrophages as a first-line defense,is still not fully understood. Macrophages produce reactive oxygen species (ROS)molecules as a result of oxygen bursts to eliminate antigens. Nitric Oxide (NO) andmyeloperoxidase (MPO) play a role in oxygen burst. Also, phagocytosis process involvedlysosomal organelles in which there are hydrolase enzymes (acid phosphatase and betaglucuronidase),which have important role in intracellular digestion. This study examinedthe hypothesis about impairment of macrophage function in spondylitis TB patients.Monocytes were isolated from peripheral blood mononuclear cells (PBMC) collectedfrom five spinal TB patients and five healthy people as controls. Isolated monocytes werecultured by stimulation of macrophage colony-stimulating factor (M-CSF) for seven daysfor maturation. The phagocytic ability of macrophages is assessed as to their activity onsheep red blood cells. Whereas nitric oxide (NO), myeloperoxidase (MPO), betaglucuronidase,and acid phosphatase activity were investigated by spectrophotometermethods. Data was analyzed using SPSS version 20. We found that monocytes isolatedfrom PBMC of spondylitis TB patients were significantly less than in the control group(2992,103 vs 6474,103 (cells / mL)) and also fewer macrophages attached to red bloodcells sheep (264,103 vs 598,103 (cells / mL)). However, NO production (2346 vs 325.17(μmol / gram protein)), MPO (570.7 vs. 17.4 (units/mg), beta-glucuronide (0.149 vs 0.123(units/mg)), and acids phosphatase activity (1776.9 vs 287.9 (units/mg)) of macrophagesin the spondylitis TB group were higher than in the healthy group. There was a strongand significant negative correlation between phagocytosis of macrophages with each ofthe previous variables. There was no significant difference between phagocytic abilityand the WST test. Although the recognition against foreign bodies was low, intracellularmacrophage processes, including oxidative activity and lysosomal function, weresignificantly higher than control. This result showed a decrease of macrophage functionin spondylitis TB patients as well as a possible dominance of non- specific immunity."

"Pendekatan sistem imun pada pejamu M. tuberculosismerupakan salah satu pilihan dalam pengembangan terapi tuberkulosis, terutama pada kasus tuberkulosis (TB)  resisten obat. Tujuan penelitian ini adalah untuk menganalisis perbedaan fungsi makrofag pada penderita TB resisten obat dibandingkan dengan kontak erat yang terinfeksi laten dan sehat. Sel Monosit Darah Tepi (SMDT) diisolasi dan dikultur selama 7 hari. Fagositosis dinyatakan jika terdapat minimal satu sel darah merah domba tampak melekat pada membran makrofag. Kemampuan lisosom diperiksa dengan uji aktivitas enzim fosfatase asam. Enam pasien TB-RO dan 18 kasus kontak erat (8 TB laten;10 sehat) di RS Universitas Indonesia direkrut sebagai subjek penelitian. Hasil menunjukkan bahwa aktivitas fagositosis kelompok infeksi laten lebih tinggi dibandingkan kelompok sehat dan TB RO (one-way ANOVA, p<0,05). Aktivitas enzim fosfatase asam lebih tinggi pada kelompok TB RO. Perbedaan fungsi makrofag ini diharapkan dapat menjadi referensi selanjutnya dalam terapi TB RO ataupun terapi pencegahan. 

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The immune system approach to the host of M. tuberculosis is an option in developing tuberculosis therapy, especially in drug-resistant tuberculosis (DR-TB) cases. This study aimed to analyze the differences in macrophage function in drug-resistant TB patients compared to close contacts who were latently infected and healthy. Peripheral Blood Mononuclear Cell (PMBC) was isolated and cultured for seven days. Phagocytosis is expressed when at least one sheep red blood cell appears attached to the macrophage membrane. The ability of lysosomes was examined by testing the activity of the acid phosphatase enzymes. Six DR-TB patients and 18 close contact cases (8 LTBI; 10 healthy) at Universitas Indonesia Hospital were recruited as research subjects. The results showed that the phagocytosis activity of the latent infection group was higher than that of the healthy and TB RO groups (one-way ANOVA, p<0.05). Acid phosphatase activity was higher in the DR-TB group. The difference in macrophage function is expected to be a further reference in DR-TB treatment or preventive therapy."

"Latar Belakang: Infeksi merupakan penyebab kematian yang penting pada thalassemia. Peningkatan risiko infeksi disebabkan oleh banyak faktor antara lain karena kelebihan besi dan splenektomi. Penelitian ini bertujuan mengetahui perbedaan fungsi fagositosis monosit pada pasien thalassemia mayor pasca splenektomi dan non splenektomi serta mengetahui hubungan fungsi fagositosis monosit dengan kadar feritin serum. Metode: Penelitian dilakukan di Departemen Patologi Klinik RSCM, Jakarta pada September 2013 ? Februari 2014. Desain penelitian potong lintang, dengan subjek penelitian pasien thalassemia mayor, terdiri dari 58 subjek pasca splenektomi dan 58 subjek non splenektomi yang telah dilakukan macthing umur dan jenis kelamin. Dilakukan pemeriksaan fagositosis monosit menggunakan E.coli yang telah diopsonisasi dan dilabel FITC sebagai target, (PhagotestTM) dan diperiksa dengan flow cytometry BD FACSCalibur. Kadar feritin serum diperiksa dengan Cobas e 601. Hasil: Median fagositosis monosit pada 58 subjek pasca splenektomi 5,03 (0,17 ? 22,79) %, dan pada 58 subjek non splenektomi 7,09 (0,11 ? 27,24) %, dan nilai p > 0.05. Kadar feritin serum pada subjek pasca splenektomi 6.724 (644,60 ? 21.835) ng/mL dan subjek non splenektomi 4.702,50 (1.381 ? 14.554) ng/mL, dan nilai p < 0.05. Hasil uji korelasi fungsi fagositosis monosit dengan kadar feritin didapatkan r = 0.13 (nilai p = 1.00). Kesimpulan: Tidak terdapat perbedaan bermakna antara fungsi fagositosis monosit pada pasien thalassemia mayor pasca splenektomi dan non splenektomi. Kadar feritin serum pada pasien thalassemia mayor pasca splenektomi lebih tinggi secara bermakna dibandingkan non splenektomi. Tidak didapatkan hubungan antara fagositosis monosit dengan kadar feritin serum.

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Background: Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level.

Methods: The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 ? Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601.

Result: Median phagocytosis of monocyte was 5,03 (0,17 ? 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 ? 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 ? 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00).

Conclusion: There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level."

"ABSTRAKLatar belakang : Beberapa penelitian terakhir menunjukkan infiltrasi masif dari monosit berhubungan dengan resiko berat badan lahir rendah pada janin. CD 68 dapat digunakan untuk mendeteksi sel inflamasi monosit/makrofag dalam melihat respon imunitas maternal dalam melawan infeksi malaria dalam kehamilan. Tujuan penelitian ini untuk mengetahui ekspresi CD 68 berdasarkan kriteria histopatologik malaria plasenta. Metode : Studi potong lintang jaringan biopsi plasenta dengan diagnosis histopatologik akut, kronik, lama dan non infeksi. Sampel penelitian dipulas dengan pewarnaan imunohistokimia CD 68, diidentifikasi, dan dianalisa hubungan ekspresi CD 68 berdasarkan diagnosis histopatologik, inflamasi monosit dan berat badan lahir.Hasil : Ekspresi CD 68 positif dengan nilai rata-rata 0,91 0,62. Ekspresi CD 68 lebih tinggi pada malaria plasenta akut dibandingkan dengan kelompok lainnya dengan nilai rata-rata 1,66 0,35 . Ekspresi CD 68 pada inflamasi monosit sedang lebih tinggi dibandingkan dengan inflamasi monosit minimal p = 0,033 . Tidak didapatkan hubungan bermakna antara CD 68 dengan berat badan lahir bayi p = 0,574 . Kesimpulan : Ekspresi CD 68 positif umumnya pada malaria plasenta akut dan inflamasi sedang, yang dapat mempengaruhi prognosis dan terapi.

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ABSTRACTBackground Several recent studies have shown that massive infiltration of monocytes is associated with low birth weight risk. CD 68 can be used to detect monocyte macrophage inflammatory cells in view of the response of maternal immunity against malarial infections in pregnancy. The aim of this study was to determine the expression of CD 68 based on histopathologic criteria of placental malaria. Objective Cross sectional study of placental biopsy tissue with histopathological diagnosis as acute, chronic, long and non infectious. The study sample was stained with CD 68 antibody and analyzed the association of expression CD 68 with histopathologic diagnosis, monocyte inflammation and birth weight. Results CD 68 expression was positive with mean score was 0.91 0.62. CD 68 expression was higher in acute placental malaria compared with other groups mean, 1.66 0.35 . CD 68 expression on monocyte inflammation was higher than on minimal monocyte inflammation p 0.033 . There was significant correlation between histopathological diagnosis with monocyte inflammation p 0,025 . There was no significant association between CD 68 and birth weight p 0,574 . Conclusion Positive CD expression 68 is common in acute placental malaria and mild inflammation, which may affect prognosis and therapy. Keywords CD expression 68 placental malaria histopathologic diagnosis immune system "

"Tuberkulosis masih menjadi masalah kesehatan utama karena prevalensinya yang terus meningkat, terutama kasus TB resisten obat. Penelitian ini bertujuan untuk menganalisis respons adaptasi makrofag terhadap hipoksia dan kemampuan fagositosis makrofag pada penderita TB resisten obat dibandingkan dengan kontak erat yang terinfeksi laten dan sehat. Enam pasien TBRO dan 18 kasus kontak erat (8 TB laten; 10 sehat) di RS Universitas Indonesia direkrut sebagai subjek penelitian. Makrofag berasal dari hasil isolasi sel mononukleus darah tepi (SMDT) subjek yang dikultur selama 7 hari. Pemeriksaan ekspresi mRNA dan protein HIF-1α dilakukan menggunakan qRT-PCR dan ELISA. Hasil menunjukkan bahwa aktivitas fagositosis kelompok infeksi laten lebih tinggi dibandingkan kelompok sehat dan TB RO (p<0,05). Ekspresi mRNA dan protein HIF-1α lebih tinggi pada kelompok TB RO dibandingkan kelompok lainnya (p<0,05). Terdapat korelasi negatif sedang antara kemampuan fagositosis dengan ekspresi protein HIF-1α (r = -0,612; p<0,05). Perbedaan respons adaptasi hipoksia dan fungsi sel makrofag diharapkan dapat menjadi referensi selanjutnya dalam membuka penelitian yang lebih spesifik, untuk menelusuri lebih lanjut dari aspek lain mengenai respons imun makrofag pada penderita TB resisten obat dibandingkan dengan kontak erat terdiagnosis laten TB, dan kontak erat yang sehat.

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Tuberculosis remains a major health problem due to its increasing prevalence, especially in cases of drug-resistant TB. This research aims to analyze the macrophage adaptive response to hypoxia and the phagocytic ability of macrophages in patients with drug-resistant TB compared to close contact with latent infection and healthy individuals. Six drug-resistant TB patients and 18 close contact cases (8 latent TB; 10 healthy) at the University of Indonesia Hospital were recruited as research subjects. Macrophages were derived from the PBMC of the subjects and cultured for 7 days. Examination of HIF-1α mRNA and protein expression was conducted using qRT-PCR and ELISA. The results showed that the phagocytic activity of the latent infection group was higher compared to the healthy and drug-resistant TB groups (p<0,05). HIF-1α mRNA and protein expression were higher in the drug-resistant TB group compared to the other groups (p<0,05). However, there was a moderate negative correlation between phagocytic ability and HIF-1α protein expression (r = -0,612; p<0,05). The differences in hypoxia adaptive responses and macrophage cell function are expected to serve as a reference for further, more specific research to explore other aspects of macrophage immune responses in drug-resistant TB patients compared to close contacts diagnosed with latent TB and healthy close contacts."

"Ethanol 70% and water extracts of alpinia spp. i.e. alpinia zerumbet, A. Katsumadai. A. malaccensis and A. officinarum were examined for their impact in in-vitro phagocytosis activity and capacity of mouse (mus musculus) peritoneum macrophage induced by staphylococcus epidermis. The extract concentrations used in this experiment were 0; 0.1; 1.0; 10; 100 ml, imboost (echinacea purpurea extract) 1000 ml was used as positive control while distilled water as negative control. The assay result showed that all of the extract were activity to promote phagocytosis activity and capacity of macrophage cells. The phagocytosis activity and capacity were increases by increasing extract concentration, and ethanol extract showed better activity than water extract. Alpina officinarum and A. Katsumadai extract reveal better phagocytosis activity and capacity than others. Activity and capacity of phagocytosis of each concentration was significantly (p<0,05) different each other as well as with negative control. There is significant difference among each extracts and positive control at 1000 ml"

"Air Susu Ibu tidak hanya mengandung nutrisi namun juga sel-sel imun untuk melindungi bayi dari patogen pada awal kehidupannya. Salah satu sel yang berperan penting adalah makrofag (CD14+ mononuclear cells), sebagai komponen dari sistem kekebalan bawaan bagi bayi. Penelitian ini bertujuan untuk menganalisis perbandingan populasi, viabilitas serta kemampuan fagositosis CD14+ mononuclear cells ASI dan darah tepi. Total 20 subjek dianalisis populasi CD14+ mononuclear cells, M1 (CD86) dan M2 (CD206) dengan flow cytometry. Viabilitas sel dianalisis dengan CCK assay dan kemampuan fagositosis dengan sheep red blood cell (SRBC). Hasil penelitian menunjukkan bahwa populasi CD14+ mononuclear cells ASI lebih tinggi 20% dibanding darah tepi (38,93 ± 5,29% versus 1,88 ± 0,55%, p=0.0005). Populasi CD14+ mononuclear cells ASI terbukti memiliki kemampuan polarisasi yang ditandai dengan ekspresi M1 (CD86) dan M2 (CD206). Ratio M1/M2 pada ASI adalah < 1, namun tidak memiliki perbedaan signifikan dengan darah tepi (p=0,238). Viabilitas dan kemampuan fagositosis CD14+ mononuclear cells ASI secara signifikan lebih tinggi dibandingkan darah tepi (viabilitas, p=0,0032; kemampuan fagositosis, p=0,0001). Hasil penelitian ini menunjukkan bahwa CD14+ mononuclear cells ASI mempunyai populasi yang lebih tinggi dengan polarisasi dominan M2, serta mempunyai viabilitas dan kemampuan fagosistosis yang lebih baik daripada CD14+ mononuclear cells yang berasal dari darah tepi.

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Breast milk contains nutrients and immune cells that protect infants from early-life pathogens. Macrophages (CD14+ mononuclear cells), play a crucial role as a component of the innate immune system in infants. This study compared the populations, viability, and phagocytic ability of CD14+ mononuclear cells derived from breast milk and peripheral blood in 20 subjects. The population of CD14+ mononuclear cells, M1 (CD86), and M2 (CD206) were analyzed using flow cytometry. Cell viability was assessed using the CCK assay, and phagocytic ability was measured with sheep red blood cells (SRBC). The results showed that the CD14+ mononuclear cell population in breast milk was 20% higher than in peripheral blood (38.93 ± 5.29% versus 1.88 ± 0.55%, p=0.0005. Breast milk CD14+ mononuclear cells exhibit M1 (CD86) and M2 (CD206) polarization, with an M1/M2 ratio <1, compared to peripheral blood (p=0.238). The viability and phagocytic ability of CD14+ mononuclear cells in breast milk were significantly higher compared to those in peripheral blood (viability, p=0.0032; phagocytic ability, p=0.0001). These findings indicate breast milk CD14+ mononuclear cells have a higher population with dominant M2 polarization, viability, and phagocytic ability compared to those from peripheral blood."

"Latar belakang: Pasien tuberkulosis (TB) paru rentan mengalami infeksi oportunistik, termasuk oleh Aspergillus (aspergilosis paru). Keberadaan Aspergillus dikonfirmasi dengan uji kultur. Uji kepekaan Aspergillus terhadap obat anti-jamur (OAJ) dilakukan untuk mengetahui pilihan OAJ yang tepat. Itrakonazol merupakan salah satu OAJ pilihan untuk aspergilosis paru. Resistensi OAJ dapat disertai gejala klinis yang luas. Penelitian ini bertujuan untuk mengetahui karakteristik klinis pasien dikaitkan dengan hasil uji kepekaan Aspergillus terhadap itrakonazol.Metode: Penelitian potong-lintang ini dilakukan pada Juli-November 2021 dan merupakan bagian dari penelitian sebelumnya. Isolasi Aspergillus dari sputum pasien TB paru dilakukan menggunakan medium agar Sabouraud. Karakteristik klinis yang diteliti meliputi usia, jenis kelamin, indeks massa tubuh (IMT), dan gejala. Adapun uji kepekaan jamur dilakukan dengan metode cakram sesuai protokol.Hasil: Penelitian ini menyertakan 28 isolat Aspergillus sp. yang berasal dari sputum 28 pasien TB paru. Jumlah pasien laki-laki lebih dominan (24 orang). Rerata usia 50 ± 15,1 tahun, dengan kelompok usia terbanyak < 60 tahun (21 pasien). Sebanyak 12 pasien (42,9%) memiliki IMT rendah. Gejala klinis yang didapatkan meliputi: batuk (42,9%), batuk darah (35,7%), sesak (39,3%), nyeri dada (14,3%), dan rasa lelah (35,7%). Kultur sputum menunjukkan pertumbuhan 28 isolat Aspergillus, terdiri atas: 14 isolat Aspergillus fumigatus, 6 isolat Aspergillus flavus, dan 8 isolat Aspergillus niger. Uji kepekaan Aspergillus terhadap itrakonazol menunjukkan 23 isolat sensitif, 3 isolat intermediat, dan 2 isolat resisten. Analisis statistik menunjukkan tidak terdapat hubungan bermakna antara karakteristik klinis pasien dengan hasil uji kepekaan jamur.Kesimpulan: Tidak terdapat hubungan bermakna antara karakteristik klinis pasien dengan hasil uji kepekaan Aspergillus terhadap itrakonazol dalam penelitian ini.

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Introduction: Pulmonary tuberculosis (TB) patients are susceptible to opportunistic infections, including Aspergillus infections (aspergillosis). The presence of Aspergillus was confirmed by a culture test, followed by its susceptibility study to antifungal. Antifungal resistance is generally accompanied by serious symptoms, so clinical observations are important for better clinical awareness. This study aims to determine the relationship between clinical characteristics and susceptibility study of Aspergillus to itraconazole.

Method: This cross-sectional study was carried out from July-November 2021, as part of the previous study on aspergillosis in TB patients. Aspergillus was isolated from the sputum of pulmonary TB patients using Saboraud's agar dextrose medium. Clinical characteristics obtained through patient’s history including age, gender, body mass index, and symptoms The fungal susceptibility test was carried out by disc diffusion method according to the protocol after treatment.

Result: This study included 28 isolates of Aspergillus from the sputum of 28 pulmonary TB patients. The number of males were dominant (24 from 28 patients) than females. The mean age was 50 ± 15.1 years, with the commonest age group < 60 years (21 patients). Total of 12 patients (42.9%) had a low body mass index. Clinical symptoms included: cough (42.9%), hemoptysis (35.7%), dyspnea (39.3%), chest pain (14.3%), and fatigue (35.7%). %). The sputum culture showed 14 Aspergillus fumigatus isolates, 6 Aspergillus flavus isolates, and 8 Aspergillus niger. The susceptibility test of Aspergillus to itraconazole revealed 23 sensitive isolates, 3 intermediate isolates, and 2 resistant isolates. Statistical analysis showed that there was no relationship between the patient’s clinical characteristics and the antifungal susceptibility test of itraconazole.

Conclusion: There was no significant correlation between the patient’s clinical characteristics and the antifungal susceptibility test to itraconazole in this study"

"ABSTRAKIntroduksi Spondilitis tuberculosis (TB) merupakan kasus infeksi tulang belakang tersering terutama di negara berkembang. Tiga hingga 5% kasus Spondilitis TB berkembang menjadi deformitas kifosis >60 derajat. Deformitas kifosis dapat mengakibatkan paraplegia dan gangguan fungsi lainnya, sehingga harus ditatalaksana dan dicegah dengan koreksi operatif. Studi ini bertujuan untuk mengetahui luaran klinis dan radiologis pada deformitas kifosis pasca koreksi operatif dan hubungannya dengan faktor-faktor yang memengaruhi deformitas kifosis.Metode Penelitian ini menggunakan desain potong lintang terhadap pasien Spondilitis TB dengan deformitas kifosis yang dilakukan tindakan koreksi operatif selama tahun 2014-2018 di RSUPN Cipto Mangunkusumo. Dilakukan penilaian luaran klinis ODI (Oswestry Disability Index) dan ASIA Impairment Scale, serta penilaian radiologis berupa persentase derajat koreksi dan loss of correction. Penilaian tersebut dilakukan pada saat pra-operasi, pasca-operasi, 6 dan 12 bulan pasca operasi, serta saat kontrol terakhir.Hasil Dari 78 pasien yang diikut sertakan dalam penelitian ini, rata-rata berusia 31,4 tahun dan mayoritas perempuan. Gejala awal tersering adalah backpain. Median jumlah keterlibatan vertebra adalah 2 dengan lokasi tersering pada level torakal. Durasi kontrol adalah 6 hingga 54 bulan. Pemilihan teknik operasi posterior lebih sering digunakan dibanding kombinasi dan tidak terdapat perbedaan yang bermakna pada pemilihan teknik operasi dengan luaran klinis maupun radiologis (p>0,05). Terdapat perbedaan yang bermakna secara statistik pada perbandingan nilai klinis, dan radiologis pre dengan pasca operasi (p<0,001). Perbaikan neurologis ASIA scale tampak mulai signifikan sejak 6 bulan pasca operasi (p<0,001). Sudut kifosis awal memberikan pengaruh yang signifikan terhadap semua kategori luaran (p<0,001). Terdapat komplikasi berupa pseudoarthrosis pada 2 pasien dan defisit neurologis yang menetap pada 1 pasien. Kesimpulan Tatalaksana operasi korektif pada pasien spondilitis TB dengan deformitas kifosis menunjukkan perbaikan luaran klinis, laboratorium dan radiologis. Sudut awal kifosis mempengaruhi luaran klinis dan radiologis.

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ABSTRACTIntroduction Spondylitis tuberculosis (TB) is the most common case of spinal infection, especially in developing countries. Three to 5 % of Spondylitis TB cases will develop into more than 60o of kyphotic deformity. Kyphotic deformity can cause late paraplegia and other functional disturbances, therefore a kyphotic correction should be performed to prevent and treat the complications. The purpose of the study is to analyze the clinical and radiological outcome of kyphotic deformity in Spondylitis TB patients post kyphotic correction and to analyze the factors influencing the kyphotic deformity Method This study used cross-sectional design on Spondylitis TB patients who underwent corrective surgery as one of the treatment during 2014-2018 at Cipto Mangunkusumo Hospital. Evaluation of delta ODI (Oswestry Disability Index) and ASIA impairment scale were used to assess the clinical outcome. For radiological outcome, we assessed the percentage of correction and loss of correction. The data was collected from the medical record and also the patient; pre-surgery, post-surgery, 6 and 12 months post-surgery, also the current condition Result Out of the 78 patients included in this study, the average age was 31.4 years and for the majority of women. The majority of initial symptoms was complaint of backpain. The median number of vertebral involvement was 2, the majority of the location of the vertebrae involved were at the thoracic level. The choice of posterior surgery techniques is more often used than combination (posterior-anterior), however no significant differences was found when we compared the technique used with the clinical and radiological outcome (p>0,005) There were significant differences between pre and post-operative clinical and radiological value (p<0,001). Neurological improvement (ASIA scale) appears to be significant since 6 months postoperatively (p <0.001). Pre-operative kyphotic angle was found to be an influential factor in all outcome categories (p<0,001). There was pseudoarthrosis in 2 patients and refracter neurological deficit in 1 patient."